Female Anatomy and Physiology 2

1. Female Anatomy and Physiology 2 Anth/Soc 390 Sexuality and Gender Issues

2. Internal Sex Organs • The Vagina • The tubular female sex organ • Menstrual flow and babies pass through it • Contains penis during intercourse • Extends 3-5 inches back and upward from vaginal opening • Has three layers • Inner lining (vaginal mucosa) (endometrium) • Middle layer (muscular) (myometrium) • Outer (deeper) layer (connects vagina to other pelvic structures) (perimetrium) • Few nerve endings, especially beyond the outer 1/3

3. Internal Sex Organs Vaginitis • Vaginal inflammation - inflammation (irritation, redness, and swelling caused by the presence of extra immune cells) of the labia majora, labia minora, or perineal area, vaginal discharge, foul vaginal odor, discomfort or burning when urinating, pain/irritation with sexual intercourse • Infectious vaginitis accounts for 90% of all cases in reproductive age women: • Candidiasis albicans (a yeast), • Gardinerella (a bacterium). • Other less common infections are caused by gonorrhea, chlamydia, mycoplasma, herpes, campylobacter or some parasites • Ways to prevent vaginitis • Wash vulva and anus regularly with mild soap • Wear cotton underwear • Avoid pants tight in the crotch • Be certain that sex partner’s genitals are clean or use a condom • Use only a water-soluble jelly, such as K-Y jelly, for lubrication • Avoid diets high in sugar and refined carbohydrates • Keep track of general health

4. Internal Sex Organs • The Cervix • Lower end of the uterus • Os • Opening in the middle of the cervix • About the width of a straw; allows passage of menstrual blood and sperm • Permits passage of baby from the uterus to the vagina during childbirth (expands to width of a fist – 10 cm) • Pap test • Sample of cervical cells that screens for cervical cancer and other abnormalities

5. Internal Sex Organs • The Uterus • Hollow, muscular, pear-shaped organ in which a fertilized ovum implants and develops until birth • Cervix is the opening to the uterus and connects it to the vagina • Fundus: Uppermost part of the uterus

6. Internal Sex Organs • Layers of the Uterus • Endometrium • Innermost layer of the uterus • Endometriosis • A condition caused by the growth of endometrial tissue in the abdominal cavity or elsewhere outside the uterus, characterized by menstrual pain and, if untreated, may lead to infertility • Endometrial cancer • Myometrium • Middle, well-muscled later of the uterus • Perimetrium • Outer layer of the uterus, provides an external cover

7. Internal Sex Organs • The Fallopian Tubes • Tubes that extend from the upper uterus toward the ovaries • Help nourish and conduct ova to uterus • Cilia (hairlike projections) help move ova through tube • Ectopic pregnancy • A pregnancy in which the fertilized ovum implants outside the uterus, usually in the fallopian tube • Risk increases with age, pelvic inflammatory disease, tubal surgery, or the use of intrauterine devices (IUDs)

8. Internal Sex Organs • The Ovaries • Almond-shaped organs that produce ova and female sex hormones • Estrogen • Female sex hormones that promote the development of female sex characteristics and regulate the menstrual cycle • Progesterone • Steroid hormone that stimulates development of the endometrium and regulates menstruation • Follicle • Capsule within an ovary that contains an ovum • Ovarian cancer

9. Internal Sex Organs • Hysterectomy • Surgical removal of the uterus • Complete hysterectomy • Surgical removal of ovaries, fallopian tubes, cervix, and uterus • Partial hysterectomy • Surgical removal of the uterus only • May be performed when women develop cancer of the uterus, ovaries, or cervix and can relieve symptoms associated with various gynecological disorders • Many gynecologists believe that hysterectomies are performed too frequently (e.g., in the U.S., one woman in three by the age of 60).

10. Internal Sex Organs The Female Reproductive System

11. Internal Sex Organs

12. Internal Sex Organs • The Pelvic Examination • Recommended once a year • External examination of genitalia • Internal exam • Speculum: instrument that holds vaginal walls open • Pap smear: sample of cervical cells taken • Internal palpations to examine position, size, and possible growths on internal organs

13. Internal Sex Organs Pelvic Examination

14. The Breasts • Secondary sex characteristics • Traits that distinguish women from men • Are not directly involved in reproduction • Mammary glands • Milk-secreting glands • Areola • Dark ring on the breast that encircles the nipple • Breasts sensitive to stimulation

15. The Breasts

16. The Breasts • Breast Cancer • Mammography • A special type of X-ray test that detects cancerous lumps in the breast • Risk factors • Risk increases with age • Genetic factors linked with contraction and prognosis • Prolonged exposure to estrogen • Early onset of menstruation, late menopause, delayed childbearing or never giving birth, high amounts of fatty tissue • Heavy alcohol use

17. The Breasts • Detection and Treatment of Breast Cancer • Breast cancer is detected by having a lump in the breast, but most breast lumps are not cancerous. • Cysts: sac-like structures filled with fluid or diseased material • Benign tumors do little or no harm and are called fibroadenomas. • Malignant lumps are lethal, causing or likely to cause death. • Lumpectomy: surgical removal of a lump from the breast • Mastectomy: surgical removal of the entire breast

18. Breast Self Exam • http://video.yourtotalhealth.ivillage.com/player/?id=975341&ice=th|vid_tout|1

19. The Menstrual Cycle Menstruation • Cyclical bleeding that stems from the shedding of the uterine lining (endometrium) • Regulated by follicle stimulating hormone (FSH), luneinizing hormone, estrogen and progesterone • Divided into four phases • Averages about 28 days but variations are common • Can be influenced by psychological and physical factors

20. The Menstrual Cycle • Regulation of the Menstrual Cycle • Hypothalamus • Brain structure that regulates body temperature, motivation, emotion, and hormone production • Releases gonadotropin releasing hormone (Gn-RH) which stimulates the pituitary to release gonadotropins • Pituitary hormones that stimulate the gonads

21. The Menstrual Cycle • Pituitary gland • Gland that secretes • growth hormone, • prolactin (stimulates milk production), • oxytocin (stimulates uterine contractions in labor and the ejection of milk during nursing), and • Gonadotropins (stimulate the ovaries) • Follicle-simulating hormone (FSH) (stimulates development of follicles in the ovaries) • Luteinizing hormone (LH) (helps regulate the menstrual cycle by triggering ovulation)

22. Hypothalamus and Pituitary Glands

23. The Menstrual Cycle • Phases of the Menstrual Cycle • The Proliferative Phase (9-10 days) • The first phase during which the endometrium proliferates • Follicles develop and prepare for ovulation • The Ovulatory Phase • Second phase during which a follicle ruptures and releases a mature ovum

24. The Menstrual Cycle • The Secretory (luteal) Phase • Due to the influence of LH, the corpus luteum, the follicle that has released an ovum, secretes large amounts of progesterone and estrogen. • Hormones signal the secretion of nutrients to sustain an implanted ovum • The Menstrual Phase • If the ovum is not fertilized, estrogen and progesterone levels decline and the endometrium is removed from the body during menstruation. • Low estrogen levels result in the release of FSH, which starts the process of another proliferative phase.

25. Brain Ovary Uterus Hormone Levels

26. The Menstrual Cycle • Menopause • The cessation of menstruation • An event in the climacteric, the gradual decline in the reproductive capacity of the ovaries • Commonly occurs between the ages of 46 and 50 • Perimenopause: the beginning of menopause, which is characterized by several months of irregular or missing periods • Involves a loss of estrogen, which may have unpleasant consequences

27. The Menstrual Cycle • Symptoms that may result from estrogen loss • Night sweats and hot flashes • Headaches • Decreased vaginal lubrication during sexual arousal • Osteoporosis, which is characterized by a decline in bone density; bones become porous and brittle

28. The Menstrual Cycle • Hormone replacement therapy (HRT) • Synthetic replacement of estrogen and/or progesterone • Reduce symptoms of menopause • Associated risks: • Increased risk of breast cancer, stroke, and blood clots • May make diagnosis of breast cancer more difficult

29. Chemical Structure of Human and Synthetic Estrogen

30. Menstrual Problems • Dysmenorrhea • Pain or discomfort during menstruation • Most common type of menstrual problem • Primary dysmenorrhea • Occurs in the absence of known organic problems • Secondary dysmenorrhea • Caused by identified organic problems • Endometriosis, pelvic inflammatory disease, ovarian cysts • Menstrual cramps can be a cause of secondary dysmenorrhea – prostaglandins cause contractions

31. Menstrual Problems • Amenorrhea • The absence of menstruation • Primary amenorrhea • Lack of menstruation in a woman who has never menstruated • Secondary amenorrhea • Lack of menstruation in a woman who has previously menstruated • Is frequently associated with being underweight and/or with excessive exercise • Is a symptom of anorexia nervosa • Sometimes happens to female athletes

32. Menstrual Problems • Premenstrual Syndrome (PMS) • Physical and psychological symptoms that may afflict women during the four- to six-day interval that precedes menstruation • Premenstrual Dysphoric Disorder (PMDD) • A diagnosis used by the American Psychiatric Association to describe cases of PMS that are characterized by severe changes in mood and impaired functioning at work or school or in social relationships

33. Menstrual Problems • Symptoms of PMDD: • Feeling sad, hopeless, or worthless • Tension, anxiety, feeling on edge • Frequent crying, significant mood changes • Irritability and anger, causing interpersonal conflict • Decreased interest in activities and relationships • Difficulty concentrating • Fatigue, lethargy, lack of energy • Notable changes in appetite (increased, decreased, cravings) • Sleeping too much or difficulty sleeping • Feeling overwhelmed or out of control • Other physical symptoms: headache, pain, weight gain